A while ago a man came to my clinic presenting with a strange red rash, which was present on only one side of his body, and was intensely itchy. Previous doctors had told him he simply had eczema and, as usual, prescribed him steroid creams and antihistamines in the hopes that his condition would subside. Unfortunately nothing seemed to help and so the itching continued on. By the time this patient came in to see me he had been suffering for 2 years already.
Upon investigation it became evident that the itching started upon his return from a vacation in India. He mentioned receiving a nasty mosquito bite on his forearm, from which left no rash to speak of, only intense itching. The itching continued and over the course of a year and a few months red bumps started appearing in the area where he scratched, as well as much dryness, for which moisturizing creams could not help. The man was otherwise healthy and had not suffered with skin disease at any other time in his 50+ years of life.
My diagnosis for this man was Lichen simplex, often known in Chinese medicine as niu pi xuan (Ox skin dermatosis), which is an extremely itchy skin condition that is often self perpetuated through constant scratching. It is usually only found in areas of the body that can be reached by scratching, and is often only one sided, thus differing from other itchy conditions like eczema or psoriasis which will tend to manifest symmetrically on the body. The origin of the itch can be from stress, nervous habit or, as in the case I present here, a simple mosquito bite. The need to alleviate the itch through scratching perpetuates the itch itself, leading to dryness of the skin and the appearance of an actual rash which may not have been present before. So in a way, lichen simplex is a self induced condition, as it is due to repeated bouts of scratching that deteriorate the skin and creates more itching – thus called the scratch-itch-scratch cycle.
In order to alleviate the lichen simplex one must then stop scratching. The cycle must be broken. I decided to give this man a lotion that I hand-make here in the clinic which uses such anti-itch medicinals as peppermint oil and calamine (a medicinal mineral). He was to apply the lotion 6, or more, times per day, or basically whenever he felt itchy. We wanted to try and stop the scratching cycle so that the skin could heal itself. I decided to not give any internal medicines at this point, as his condition did not seem too severe to me, and I felt rather confident that the lotion would suffice. Sure enough, over the course of a couple weeks his rash disappeared and his itching subsided.
This was his update to me:
“Dr. Erikson, I just want to update you since my appointment 2 weeks ago. The lotion you provided has worked very well in decreasing the itch and as a result my rash has completely cleared up. I was not expecting such quick results after having this for almost 2 years and am very pleased with the outcome to date. Thanks again.”
As many of my teachers of Chinese medicine have pointed out, “the right diagnosis leads to the right treatment, which then leads to the right outcome.”
Wishing you health,
Dr. Trevor Erikson
Copyright © 2019 Dr. Trevor Erikson